Distorted picture of Broughton misses the bigger story

I recently had the opportunity to view the documentary “America’s Most Haunted Asylum: Broughton Hospital,” a viewing sponsored by the Burke Arts Council.

Unfortunately, and as anticipated, the production appeared designed less to provide historical perspective than to perpetuate the mythology and stigma surrounding mental health care in our country, with Broughton Hospital squarely in its crosshairs.

As someone who has devoted an entire career to public mental health, including many years at Broughton, I am certainly no stranger to the myths and legends surrounding state psychiatric hospitals.

Morganton has long benefited from the economic contributions of its state institutions. Yet, much like the local chicken plant, the community often seems content to enjoy the benefits of these institutions without necessarily wanting to understand more clearly what happens behind their walls and take measures to improve the standards within — to the betterment of all involved.

In what amounts to an unfortunate exercise in sensationalism, the Burke Arts Council and the documentary’s producers chose to use this opportunity to undermine both the individuals who need mental health care and the dedicated professionals who have spent their careers serving the severely mentally ill population of western North Carolina.

These professionals have done so with commitment and compassion, often for substandard wages and with limited resources.

The documentary emphasized psychiatric treatments from a century ago, portraying them as barbaric and dehumanizing without acknowledging that many represented the leading medical practices of their time.

A similar documentary could easily highlight the medical practices of physical health care 100 years ago and portray them as equally primitive.

Medicine is an evolving science: knowledge advances, evidence emerges, and clinical practices change. There is little doubt that some historical institutional practices were genuinely harmful, however that historical evaluation requires context in that they were the evidence based practices of the period.

My sincere hope is that, 100 years from now, our current psychiatric and medical practices will likewise be viewed as outdated and remarkably ineffective. That is the nature of medical progress.

Judging historical practices exclusively through the lens of contemporary standards, without providing appropriate historical context, does a disservice to an accurate understanding of the past.

And then there is the matter of the haunting. The suggestion that Broughton is haunted is simply laughable. There are currently no ghosts at Broughton, nor have there ever been.

The stories are products of imagination, embellishment, and folklore. I have spent many third-shift hours in the Avery Building, including on the darkest summer nights amid impressive thunderstorms.

I was fully prepared to encounter a ghost or two. Unfortunately for the paranormal enthusiasts, I was consistently disappointed. The only disturbances were the rumbling thunder echoing through the magnificent halls of this architectural masterpiece.

The documentary’s treatment of eugenics was another troubling example of historical oversimplification.

The producers attempted to establish a connection between Broughton and the broader national eugenics movement, suggesting a level of institutional involvement that warrants considerably more historical context and substantiation.

While state psychiatric hospitals existed within the broader social and political environment in which eugenics policies developed, the documentary appeared to portray these institutions as central participants in a practice that was both reprehensible and deeply consequential.

Similarly, the producers characterized the state hospital farm system as little more than a network of labor camps, in the mind’s eye drawing comparisons to correctional institutions and subjugation.

This portrayal overlooked the potential therapeutic, vocational, and social value of meaningful work, productive activity, and the opportunity for patients to contribute to a larger community.

Historical practices deserve pointed and honest examination, but that examination should be balanced and informed rather than driven by sensationalism.

Perhaps most disappointing, however, was the documentary’s failure to address one of the most consequential developments in American mental health care: the deinstitutionalization movement and the subsequent dismantling of much of the state hospital system and the area programs that provided community based care.

Beginning in the 1960s, enthusiasm surrounding the emergence of modern psychopharmacology fueled the belief that individuals with serious mental illness could be transitioned out of state hospitals and successfully supported in less restrictive community settings.

The prevailing expectation was that resources would follow patients into the community and that an appropriate infrastructure of outpatient services, housing, and support would develop to meet their needs.

Unfortunately, that vision was never fully realized. Funding did not adequately follow patients into the community, the novel medications proved far from universally effective, and inadequate reimbursement and insufficient infrastructure limited the development of sustainable community-based services.

Meanwhile, beginning in the late 1960s and continuing for decades, the United States substantially expanded its correctional system. The consequences of this failed transition remain evident today.

Bureau of Justice Statistics data and other national research have consistently documented the disproportionate representation of individuals with mental illness and substance use disorders in correctional settings.

Estimates suggest that as many as 70% of incarcerated persons have a mental health condition, a substance use disorder, or both.

In effect, as the state hospital system contracted, far too many individuals with serious mental illness found themselves in jails, prisons, homeless shelters, or living on the streets without adequate treatment or support.

That is the real tragedy here and requires no further sensationalization.

This is the larger story that deserved attention. The dismantling of the state hospital system was not accompanied by the development of a sufficiently funded and comprehensive community mental health infrastructure.

What was envisioned as a more humane and effective model of care too often resulted in individuals being transferred from one inadequate system to another — or left without meaningful services altogether.

This history deserves far more scrutiny than the sensationalized stories of ghosts and institutional folklore.

My central point is straightforward: mental health care in this country has suffered for decades from inadequate political attention and a persistent unwillingness to commit the resources necessary to meet the needs of this vulnerable population.

Like public education, mental health care has too often been treated as a secondary priority rather than an essential public responsibility.

To criticize Broughton Hospital and the public mental health system for their historical shortcomings while failing to acknowledge the broader context, the evolution of medical science, the dedication of its workforce, and the chronic underfunding that continues to constrain its mission is profoundly unfair.

The documentary offered an opportunity to educate the public about the complicated history of mental health care, the challenges facing state psychiatric hospitals, and the consequences of decades of policy decisions.

Instead, it relied heavily on sensationalism and selective historical interpretation.

I spent many years at Broughton and have witnessed firsthand the dedication of the people who work there and the challenges inherent in caring for individuals with the most serious mental illnesses.

They deserve a more thoughtful and balanced portrayal. More importantly, so do the individuals and families who depend on these services.

Perpetuating myths and stigma does nothing to advance mental health care. It only further marginalizes those who need treatment and those who have dedicated their professional lives to providing it.